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Decreased expression of A20 is associated with ocular Behcet’s disease (BD) but not with Vogt-Koyanagi-Harada (VKH) disease
  1. Yue He1,
  2. Chaokui Wang1,
  3. Guannan Su1,
  4. Bolin Deng1,
  5. Zi Ye1,
  6. Yang Huang1,
  7. Gangxiang Yuan1,
  8. Aize Kijlstra2,
  9. Hong Li1,
  10. Peizeng Yang1
  1. 1 The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, Chongqing, China
  2. 2 University Eye Clinic Maastricht, Maastricht, The Netherlands
  1. Correspondence to Dr Peizeng Yang, The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ophthalmology and Chongqing Eye Institute, Chongqing, China; peizengycmu{at}; Professor Hong Li; lihongcqmu{at}


Purpose A20 is a ubiquitously expressed and inducible cytosolic protein, which plays an important role in the negative regulation of inflammation and immunity. In this study, we investigated the role of A20 in Behcet’s disease (BD) and Vogt-Koyanagi-Harada (VKH) disease.

Methods The levels of A20 in peripheral blood mononuclear cells (PBMCs) and dendritic cells (DCs) were detected in BD patients with active and inactive uveitis, VKH patients with active and inactive uveitis, and normal subjects, respectively, by real-time PCR. The effect of A20 silencing was performed by transduction of DCs with adenovirus containing an A20 shRNA vector. The effect of A20 silencing on the maturation of DCs was measured by flow cytometry. The effect of A20 silencing of DCs on cytokine production by DCs and CD4T cells was analysed by ELISA. The phosphorylation levels of JNK, p38 and ERK1/2 were detected by flow cytometry.

Results The expression of A20 was markedly decreased in PBMCs and DCs obtained from BD patients with active uveitis, but not in patients with VKH disease as compared with normal controls. Silencing of A20 significantly increased the levels of interleukin (IL)-1β and IL-6 and suppressed the expression of the anti-inflammatory cytokines IL-10 and IL-27. Downregulation of A20 also led to an increase in IL-17 production by CD4T cells. However, downregulation of A20 in DCs did not have an effect on cell surface markers such as CD40, CD80, CD83, CD86 and HLA-DR. Silencing of A20 caused an increased expression of phospho-JNK and phospho-MAPK p38 but not phospho-ERK1/2.

Conclusions This study showed that the expression of A20 was decreased in BD patients with active uveitis but not in VKH disease. Decreased expression of A20 may lead to an enhanced activation of proinflammatory Th17 cells, causing a reactivation of BD.

  • Behcet’s disease
  • VKH disease
  • A20
  • dendritic cells
  • adenovirus

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  • Correction notice This article has been corrected since it was first published online first. Author name Aize Kijlstra was incorrectly presented.

  • Contributors YuH, PY and HL: conceived the idea and designed the experiments. YuH, BD, ZY and YaH: performed all the experiments. GY: flow cytometry test. CW, GS and KA: revised the manuscript. All authors reviewed the manuscript.

  • Funding This work was supported by the National Natural Science Foundation Project (81470622, 81770913), Chongqing Science & Technology Platform and Base Construction Program (cstc2013jcyjA10008).

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The study was approved by the Clinical Ethical Committee of the First Affiliated Hospital of Chongqing Medical University (no. 2009-201008.).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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